Wolanik Boström, Katarzyna

Öhlander, Magnus

Abstract [en]

In the paper, we discuss negotiations of the professional role that makes the practise of expertise knowledge (fully) possible, taking our study of as a point of departure. In the case of physicians, there is a common assumption that their knowledge and skills are transnational, spatially unbound and easily transferable from one setting to another. In our study, the Polish doctors migrating to Sweden, England or France tell that both strictly theoretical research and “hands-on”- skills where good results can be quickly observed (e.g. in surgery or anaesthesiology) are easily transferable. Other kinds of experiential and more culturally specific knowledge (e.g. communication with patients or strategies for health-care organizing) are, however, often encountered with disinterest in a new national setting or get more easily “lost in translation”. Some of the Polish doctors tell that the Swedish colleagues treat the Swedish health-care as superior in every aspect and show little interests in learning from the former East Europeans’ experience – even if their experiential knowledge may be more complex.

Additionally, the skills required of a doctor are often much wider than just medical or administrative. When they come to Sweden, France or England, they do it on the basis of a transnationally valued diplomas and professional practise in the (ideal type of?) overarching, transnational medical field where the expert knowledge is supposed to be unbound and objectively judged. But, as we conclude from our interviews, there are the concrete and tangible national and local medicalsub-fields coexisting with this transnational field. These sub-fields inhabit a whole set of complex power dimensions and cultural assumptions on the various competences, traditions, know-how, procedures etc. which fit the “proper” image of a doctor. Those are not only medical – there are expectations on the (nationally, or even locally bound, class- and gender-specific) social behaviour, life-style, embodied cultural capital (Bourdieu) marked by eloquence, body language, viable expressions of emotions and values, opinions etc. All of these prerequisites influence a migrating doctor’s possibility to perform a culturally valued professional role. The Polish doctors tell about their struggles to comprehend, navigate among, adapt to, challenge or negotiate such implicit, locally or nationally situated requirements of the doctor’s role, which lie beyond the strictly medical sphere, but still influence their professional authority. In their endeavour to become a culturally viable professional subject, they may try cultural “passing”, e.g. acting along the class- gender-, nationally etc. specific expectations and become a skilful doctor and not a skilful “Polish doctor”. Thus from the Polish professional subject, through the transnational passage, they become once more locally situated and culturally accepted professional subjects. But they may also choose the role of a colourful foreign doctor, especially if they possess a set of unique medical competences, which is of value to the local setting – as the “transnational” medical knowledge is ranked higher than the locally bound knowledge.